24A-070 ax e R 4� - ) - 4&_( - ( - -..
/ Is ;‘
r"----- _____ _
Li00111hk' \ ..
e
/� /
i .D ,
•
-
I.
Lac R_r C /4x(o fzi)erc, ;K N % R-1/4: \I
`' t.435
0) Gore , A k o\ She p 0. a wt� ?wYr Q�-Q- \kc
: it s ro . C gq) csi Q) 10a --e) f i :
Qx) 0 r-, t so Z43
c.,2...r, win cif r
c
Northampton, MA Property Detail Page 1 of 1
City of Northampton, MA: Residential Property Record !
New Search Property Type Classification Code Reference Card 1 of 1
Parcel - Location - Zoning - Assessment
Map -Block -Lot: 24A- 070 -001 Zoning: Assessment:
Location: 64 RIDGEWOOD TERR Neigborhood: 9 Land:
#Living Units: 1 Deed Book: 5672 Building:
Class: R -101 Deed Page: 97 Total:
Dwelling Information Building Sketch
Style: Contemporary
Year Built: 1993
Story Height: 2
Attic: None
32
Basement: Full
Total Rooms: 7 1Fr /OFP 7
88
Bedrooms: 3 Cli
7 8 29 2Fr /U
Full Baths: 2 24
Half Baths: 1
Exterior Walls: Alum/Vinyl 25 UA /FG
Unfinished Area: 0 Q
Ground Floor Area: 928 C 4 B
9
Total Living Area: 2056 25
Finished Basement Living 0 X 0
Area:
Basement Recreation Area: 0 X 0
Woodburning Fireplace
Stacks /Openings: 1 / 1 Addition Information:
Metal Fireplace 0 / 0
Stacks /Openings: Lower 1st Story 2nd Story 3r
Heat/Central A /C: Basic Basement One Story Frame One Story Frame L
Heating System: Hot Water One Story Frame LI
Fuel Type: Gas Open Frame Porch 1
Quality Grade: B- Frame Garage Unfinished Attic C
Physical Condition: Good Open Frame Porch One Story Frame LI
http:// www. northamptonassessor. us /noho /propertydetail.php ?map_no =24A- 070 -001 &page... 6/29/2011
..
J
, y v " \ (�)� /�j II
S
I S
. ‘ ..,'''''''''') ' ( t b t
y...S
HOME OWNER EXEMPTION ACKNOWLEDGEMENT
The State of Massachusetts allows the homeowner the right under 780CMR 108.3.4 to
act as his/her construction supervisor. The state defines "Homeowner" as, " Person(s)
who owns a parcel on which he/she resides or intends to be, a one or two family
dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two -year period shall not be considered a
home owner."
The building department for the City of Northampton wants person(s) who seek to use
the home owner exemption, to act as their own construction supervisor, to be aware that
by doing so you become responsible for compliance with state building codes and
regulations. The inspection process requires that the building department be called to
inspect work at various stages, which include foundation /footings (before backfill).
sonotube holes (before pour). a rough building inspection (before work is
concealed). insulation inspection (if required and a final building inspection. The
building department requires these inspections before the work is concealed, failure to
secure these inspections can result in failure to obtain a certificate of occupancy
until the work can be inspected.
If the homeowner hires other trades to perform work (electrical, plumbing & gas) the
homeowner will be responsible to make sure that the trades hired secure their proper
permits in conjunction to the building. permit issued, and that they get their required
inspections. Failure of the individual trades to secure the pert its and inspections as
required can DELAY the project til such time as the proper permits and inspections are
made
I, understand the above.
(Home owner /resident's signature requesting exemption)
I will call to schedule all required building inspections necessary for the building permit
issued to me.
Date
Address of work
location
• i Jie Conzlnonwea %th of MMassach setts
= rx Department of Industrial _A cciderzts
Oj17,ce ofInvesti ario �zs
600 iT'ashinguon Street
Boston, 1414 02111
n'x'. mass.goi /dig
Workers' Compensation Insurance Affidavit: Builders/ Contractors /Electricians!Plumbers
Applicant Information PIease Print Legibly
Napa ( Business /Organization/Individuali: y(-�FSA \ Q .,SS
Address: — S - 3 .� 5 1,
City /State /Zip: . � t CS , (41 C'. '' (°
Arree y ou an employer? Check the appropriate box: Type of project (required):
1. L1 1 am a employer with 4. n I am a General contractor and I 6. ❑ New consuuction
employees (full and/or part-time).* have hired the sub contractors
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub - contractors have S. 0 Demolition
working for me in any capacity. employees and have workers' Q
y 9. ❑ Buildin addition
f o workers' comp. insurance come. insurance.
required..] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3. ❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t c. 152, § 1(4), and we have no 13. ❑ Other
employees. [No workers'
I comp. insurance required.]
*Any applicant that checks box #1 must aiso 511 out the section below showing their workers' compensaffon policy information.
Homeowners who submit this affidavit indicating they are doing ail work and then hire outside contractors must submit a new affidavit indicating such.
'Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and state whether or not those entities have
errnloyees. If the sub - contractors have employees, they must provide their workers' comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: Q �� \ \‹ �' `C'n 0 o'` ' � ` , ,Q -.; C._O . _
Policy T or Self -ins. Lic. 4: k ' .- -- 1 c- € ° ' 1 c. "' ' Expiration Date: la Li \ e
Job Site Address: t.: D-1.~ a C Q �ci � /Zip: C;1 t .
•
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to S1,500.00 and/or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to 3250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DLk for insurance coverage verification.
I do hereby terrify under the pa's and pe• aloe ofp,erjury that the information provided abo is r ue and correct.
Signature: .'! <' /�/ ` i /� Date:
" l/
Phone 4: (r,��� cV d �=
O fticial use only. Do not write in this area, to be completed by city or town officiaL
City or Town: Permit/License 4
Issuing Authority (circle one):
1 1. Board of Health 2. Building Department 3. City /Town Clerk 4. Electrical Inspector 5. P ?u. Bing Inspector
6.Other �
1
i. Contacr Person: Phone =:
SECTION E - CONSTRUCTION SERVICES
2.1 Licensed Construction Superrsor: I Not Applicable ❑
Name of License Helder :VA`12S` ---.) .3--"D
License Number
s‘abreas Expiration Date
signature Telephone
r_ Restistered Home ImoravemerrfContrac # or Not Applicable ❑
:omoanv Name / Registration Nu ber
ddress Expiration Date
�� Telephone) 1� t IYVr^V
ECTION 1:0- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152,,§-25C(6))
'orkers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
the denial of the issuance of the building permit..
aned Affidavit Attached Yes ❑ No ❑
11.:2;:41101ite!DilliettEiejilitiftali
The current exemption for "homeowners" was extended to include Owner - occupied Dwellinzs of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a License, provided that the owner acts
as supervisor. CNIR 780. Sixth Edition Section 108.3.5.1.
Definition of Homeowner: Person (s) who own a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two - vear period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official. that he /she shall be
responsible for all such work performed under the buildine. hermit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, von may be liable for person(s)
you hire to perform work for you under this permit.
The undersi ned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
1
1 SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) 1
New House E Addition E Replacement Windows I Alteration(s) 1 Roofing
Or Doors ` I I
Accessory Bldg. n Demolition U New Signs (C=11 Decks [( Siding [E] Other [p] I
Erief Description of Proposed \� Q I �,` _ t -..\-...4111° �,���'
Work: � l� \ � X (}� '�^ =F. �; 3 Q
Alteration, of existing bedroom Yes No Adding new bedroom v Yes 1 Y Nc
Attached Narrative Renovative unfinished basement Yes No 1 k
Plans Attached Roll - Sheet
6a. if Ne house and be addit # exi ii co thefoilo
a. Use of building \Qne Family '/ Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached? y c-3 (� ] .
d. Proposed Square footage of new construction. / ea S•' Dimensions / 4 13
e. Number of stories? eiQ .
f. Method of heating? O :;1 . ; or Wocdstoves y`e Number of each 1
g. Energy Conservation Compliance.. Masscheck Energy Compliance form attached?
h. Type of construction , ck '� cOu• -ct..... c..>, _
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodpiain Yes \i No
i. j. Depth of basement or cellar floor below finished grade �]
k. Will building conform to e Building a d Zonine reguiations? `r Yes N
1. Septic Tank - City Sewer ./ Private well City water Supply
SECTION 7a -OWNER AUTHORIZATION - T UBE COMPLETED WHEN
OWNERS AGENT OR CONTRACTO FOR BUILDING PE'i MMT
I a ■ ( L,-:, 't C ,L , as Owner of the subject
property
re y authorize S \ 4 "- v �Q.'\�` ---. \� •"�\
h e UR ( \
to act cn my behalf, in ;II matte rl -ave to work authorized by this building permit app "catio .
/ / /,,,
Signature of Owner - Date
l c�.4.. \\` a'°r...) , as Owner /Authcnzed
.gent hereby declare. that the statements and information on the foregoing application are t e and =ocurate, to the best of my knowledge
and belief.
Sicnec under the pain- and penalties of penury.
_
Print Name
Signature of Owner'Agent �aIe
t
I '
Section 4. 'ZONING i Alt Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be flied in by.
Building Depart4ient
.1
Lot Size
Frontage -_ ._
Setbacks Front _
Side L : . D . R . _ 3 _ L *-1277 R .
Rear . .m ` . Y_ 1 3,4Q _ .
Building Height Q
Bldg. Square Footage % _._,__ „.. __ ..__.
Open Space Footage _ % --
(Lot area minus bldg & paved _, ._ -_
oarkinel
# of Parking Spaces - -.- ~-
Fill:
(volume & Location) _.— ,.., —
A. Has a Special Permit /Variance /Findin ver been issued for /on the site?
NO 0 DONT KNOW YES 0
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO 0 DONT KNOW 0 YES 0
IF YES: enter Book Page mm and /or Document #
�
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW 0 YES 0
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained 0 , Dat Issued
C. Do any signs exist on the property? YES 0 NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES ON NO
IF YES, describe size, type and location:
E. Will the construction activity disturb (clearing grading, a cavation, or filling) over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES 0 NO
IF YES, the a Northampton Storm Water Management from the DPW is required.
Department use only
' City of Northarnpton Status of Permit:
REC EN Building Department Curb Cut/Driveway permit
212 Street Room 100 Water /Septic Ava
2 0U NVell Availability
* `/ it N rthampto , M A. 010 Two Sets of Structural Plans
M � phog = 13 87-1240 Fax 413 -587 12%2 Plot/Site Plans
OF suu9t tr�sPEioNS Other Specify
IAA41 . '
�L CATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
•
6,( i?„t pr -c_.:5 4caykG .( Map _ Lot Unit
Zone Overlay District
Elni St District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT l
2.1 Owner of Record:
Name (Print) Current Mailing ar s:,
o --- ,i,, .
Telephone
Signature
2.2 Authorized Agent:
Sco� C� \n =� — 3 - 3S- C.s\ eS M� N l
Name (Print) �� Current btailing Address: 37 / � `
Signature Telephone
SECTION 3 ESTIMATED CONSTRUCTION COSTS
Item I Estimated Cost (Dollars) to be I Official Use Oniy l
completed by permit apolIcant f
1. Building — Z I (a) Sui]ding Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 +2 +3 +4 +5) 3,�'t Check Number /4/c &,)v r
This Section For Official' Use Only
Date
Building Permit Number: Issued:
Signature:
Building Commissioner /Inspector_ot tiudomgs Date
,tst t4i* tt • * * ...." •
1.4141.v;•.-e
. • •
• • f 14 •
• 4
•
41
File # BP- 2011 -1106 v1S� � J tJ
APPLICANT /CONTACT PERSON HARLOW BUILDERS ��
ADDRESS/PHONE 336 COLES MEADOW RD NORTHAMPTON (413) 586 -0465
PROPERTY LOCATION 64 RIDGEWOOD TER ;7't - C2 2h
MAP 24A PARCEL 070 001 ZONE URA(100)/
THIS SECTION FOR OFFICIAL USE ONLY: R 1 E f I► X C / T€P•
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid �''] •
Building Permit Filled out / • " " _ -' Er
Fee Paid /Yl . ariv-r k.
Typeof Construction: CONSTRUCT 14 X 13 DECK Pit/ST aye
New Construction SO Pala Dd
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License 052460
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFQRMATION PRESENTED:
''' Approved Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site Plan AND /OR Special Permit With Site Plan
Major Project: Site Plan AND /OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
Demolition Delay
6137 6 !I
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact Office of
Planning & Development for more information.
64 RIDGEWOOD TER BP- 2011 -1106
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 24A - 070 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Deck BUILDING PERMIT
Permit # BP- 2011 -1106
Project # JS- 2011- 001782
Est. Cost: $3000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: HARLOW BUILDERS 052460
Lot Size(sq. ft.): 15071.76 Owner: WILLARD FRANK P
Zoning: URA(100)/ Applicant: HARLOW BUILDERS
AT: 64 RIDGEWOOD TER
Applicant Address: Phone: Insurance:
336 COLES MEADOW RD (413) 586 -0465 Workers
Compensation
NORTHAMPTONMA01060 ISSUED ON:6/30/2011 0:00:00
TO PERFORM THE FOLLOWING WORK:CONSTRUCT 14 X 13 DECK - MUST USE
FOOTING ON CENTER SONOTUBE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House # Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace /Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
/c50/// 5
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner